Changing Your Life: Managing Your Stress

Doctors find that beating your stress only takes three easy steps.

February 11, 2010, 2:15 PM

Feb. 11, 2010— -- Everyone has their pet peeves. They are those one or two things that can put you over the edge, and make your stress and anxiety levels skyrocket.

When we asked around, people had no shortage of answers.

"Poor punctuality."

"Having to wait in line."

"The delays at the airports."

"Tailgaters on the highway," said one man, "[It's] dangerous, aggravating, rude. I can feel my heart start pumping just thinking about it."

Similar sentiments echoed here at ABC.

"Plane goes toward the runway and then halfway out it comes to a dead stop," said "Good Morning America" anchor George Stephanopoulos. "Forty-five minutes, an hour, hour and a half goes by and they tell you nothing. Drives me nuts."

"This job is pretty high stress," said senior White House correspondent Jake Tapper, echoing what many feel about their careers. "A lot of grinding of the teeth at night."

"[When] someone throws a cigarette butt," said "GMA" anchor Robin Roberts, "That gets me."

The reality here in these situations is that you can't often control what's stressing you out, but you absolutely can control how you're reacting to that stress.

For example, let's say a driver cuts in front of you while you're going 60 on the highway. Here's one response you might have: "Wow, that driver isn't being very safe." And here's another: "That %@!ing @%$ just cut me off!!!...god $@#$!!"

The difference is that when you lose your temper, the body goes into fight-or-flight mode, as if there is danger, a real threat of harm. Adrenaline levels in the blood shoot up, stress hormone levels rise, blood pressure spikes, and the heart shifts from pumping five quarts of blood a minute to shooting through 20 quarts of blood a minute.

"What's been shown in a lot of research is that people whose blood pressure goes up more when they are under stress are more likely to have heart disease 10 or 15 years down the road," says Dr. Redford Williams, a psychiatrist and head of behavioral medicine at Duke University in Durham, N.C.

"If you find yourself just continually grousing about these things and ruminating, that's a pretty good sign that you're putting yourself at risk," he adds.

Not only that, your blood is more likely to clot when you're under stress, which could lead to a stroke. Additionally, stress hormone levels spike, damaging cells in your brain, impairing your ability to remember.

It Could Be in Your Genes

"People ... who have a very low threshold to get angry," adds Williams, "people with this personality type, are anywhere from four to five times more likely by age 50 to come down with heart disease or to have died from any cause."

Williams and a team at Duke have created strategies proven to reduce stress levels in their heart patients, and these strategies hold remarkable promise for the rest of us.

The doctors at Duke actually have been able to identify genes associated with higher levels of hostility in men and women. They are hoping to use the information to create personalized medicine by identifying who is at a high risk for getting overstressed and teaching those people how to best manage difficult situations.

So what's the key to staying calm? They say it lies in asking three simple questions whenever your anger rears its ugly head.

The first: Is this important? Does this really matter?

"You could say no, it's not that important and you might be surprised at how that anger, that urge to kill, dissipates," Williams says. "Lots of people tell us that one question alone -- [for example, is it really important that the kid is spilling milk in the big scheme of things -- you might get a 'no' and you find, 'Darn, I don't feel so angry anymore.'"

If your answer is yes, move on to question two: Is it reasonable for me to be angry? Would my friends get as angry as I am right now?

"You need to chill out," Williams says. "Use a distraction, sing a song to yourself."

If you answer yes, ask yourself question three: Can I modify or change the situation?

"Three yeses means you need to take some action," Williams says. "And asking these questions -- important, appropriate, modifiable -- is putting yourself in control of, at least, your reaction. People who have this personality type can learn to manage anger better and control it. We have randomized clinical trials, gold standard in medicine to prove it."

Studies Show Men Benefit More From Stress Management

While both sexes may benefit from stress management, much of the benefit in studies has been observed in men.

A study published in 2007 showed a savings of roughly $2 for every dollar spent by hospitals on hostility interventions for male patients who came in with heart problems, showing up when they weren't rehospitalized in the following months.

Karina Davidson, director of intervention research in the Behavioral Cardiovascular Health and Hypertension Program at Columbia University and lead investigator on that study, said that part of the reason anger management is more studied in men is that it can be a greater risk factor for them than for women.

"Women often show their anger unassertively, [through] resentment or silence," she says. "It's an omission rather than yelling at someone."

While self-awareness of an anger management problem can help with intervention, a spouse can play a key part in getting that help as well. Davidson said that it is often a spouse who notices and gets her husband to seek treatment.

Of the men in her studies, "Many of them were referred by their wives, interestingly enough," she says.

She adds that awareness of stress can be important because a lot of the damage to the heart takes place in earlier years, when men are between 18 and 35. However, it is often difficult to detect heart problems as many people do not feel the effects until later in life.

So early on, Davidson says, "You've [got to] learn a style that stays with you."

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